高血压及其终生管理的性别差异。

IF 6.9 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Hypertension Pub Date : 2024-11-01 Epub Date: 2024-09-04 DOI:10.1161/HYPERTENSIONAHA.124.22980
Wan-Jin Yeo, Rahul Abraham, Aditya L Surapaneni, Pascal Schlosser, Shoshana H Ballew, Bige Ozkan, Carina M Flaherty, Bing Yu, Joseph V Bonventre, Chirag R Parikh, Paul L Kimmel, Ramachandran S Vasan, Josef Coresh, Morgan E Grams
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引用次数: 0

摘要

背景:高血压和未控制高血压的患病率可能因年龄和性别而异:高血压和未控制高血压的患病率可能因年龄和性别而异:我们纳入了社区动脉粥样硬化风险研究的参与者,他们参加了 33 年间的 7 次研究访问(访问 1:15 636 名参与者;平均年龄 54 岁;55% 为女性):高血压(收缩压≥130 mm Hg;舒张压≥80 mm Hg;或自我报告服用降压药)和未控制高血压(收缩压≥140 mm Hg或舒张压≥90 mm Hg)患病率的性别差异。结果显示高血压患病率从 40%(43-46 岁)上升到 93%(91-94 岁)。在高血压患者中,43 至 46 岁男性未控制高血压的患病率(33%)高于女性(23%),但从 61 至 64 岁开始,女性未控制高血压的患病率高于男性,91 至 94 岁女性和男性未控制高血压的患病率分别为 56% 和 40%。冠心病、糖尿病、体重指数、估计肾小球滤过率、抗高血压药物的数量、药物类别或服药依从性的差异都无法解释这种性别差异。在男女患者中,未得到控制的高血压与慢性肾病进展的较高风险相关(危险比为 1.5 [1.2-1.9];P=4.5×10-4)、心力衰竭(危险比,1.6 [1.4-2.0];P=8.1×10-7)、中风(危险比,2.1 [1.6-2.8];P=1.8×10-8)和死亡率(危险比,1.5 [1.3-1.6];P=6.2×10-19):结论:高血压和未控制高血压患病率的性别差异因年龄而异,后者对人的一生健康都有影响。
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Sex Differences in Hypertension and Its Management Throughout Life.

Background: The prevalence of hypertension and uncontrolled hypertension may differ by age and sex.

Methods: We included participants in the Atherosclerosis Risk in Communities study at seven study visits over 33 years (visit 1: 15 636 participants; mean age, 54 years; 55% women), estimating sex differences in prevalence of hypertension (systolic blood pressure ≥130 mm Hg; diastolic blood pressure ≥80 mm Hg; or self-reported antihypertension medication use) and uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) using unadjusted and comorbidity-adjusted models.

Results: The prevalence of hypertension increased with age from 40% (ages, 43-46 years) to 93% (ages, 91-94 years). Within hypertensive individuals, the prevalence of uncontrolled hypertension was higher in men (33%) than women (23%) at ages 43 to 46 years but became higher in women than men starting at ages 61 to 64, with 56% of women and 40% men having uncontrolled hypertension at ages 91 to 94. This sex difference was not explained by differences in coronary heart disease, diabetes, body mass index, estimated glomerular filtration rate, number of antihypertension medications, classes of medications, or adherence to medications. In both sexes, uncontrolled hypertension was associated with a higher risk for chronic kidney disease progression (hazard ratio, 1.5 [1.2-1.9]; P=4.5×10-4), heart failure (hazard ratio, 1.6 [1.4-2.0]; P=8.1×10-7), stroke (hazard ratio, 2.1 [1.6-2.8]; P=1.8×10-8), and mortality (hazard ratio, 1.5 [1.3-1.6]; P=6.2×10-19).

Conclusions: Sex differences in the prevalence of hypertension and uncontrolled hypertension vary by age, with the latter having implications for health throughout the life course.

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来源期刊
Hypertension
Hypertension 医学-外周血管病
CiteScore
15.90
自引率
4.80%
发文量
1006
审稿时长
1 months
期刊介绍: Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.
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